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The coexistence of thrombocytopenia and selective IgA deficiency was observed in a patient with sarcoidosis. This case report represents the first proven autoimmune thrombocytopenia in sarcoidosis. The IgA deficiency could be coincidental.

The immunochemical characteristics of granulocyte allo- and autoantibodies can easily be studied with indirect immunofluorescence techniques. The correlation of these properties with the serological behavior of the antibodies and the clinical condition in which they were found was studied. The investigations included the determination of immunoglobulin class, subclass, light-chain composition, as well as optimal temperature of activity. Complement fixation in vitro was also investigated. Striking differences were found between IgG and IgM antibodies in their serological properties, especially in the granulocytotoxicity and leukoagglutination tests at different temperatures. Differences in light-chain and IgG subclass compositions of the antibodies did not seem to play a role. In studying the distribution of granulocyte-specific antigens on normal granulocytes and granulocytes in all stages of development, it was found that, while NA1, NA2 and ND, are present in the same quantity on the cells of an individual, the NB1 antigen is unequally distributed, both over ripe granulocytes and granulocyte precursors.

For the detection of auto-antibodies on the platelets and in the serum of patients with idiopathic thrombocytopenic purpura, three new techniques have recently been developed: the quantitative antiglobulin consumption assay (QACA), the platelet radioactive anti-globulin test (PRAT) and the platelet suspension immunofluorescence test (PSIFT). The results obtained by various investigators with these techniques differ considerably. We, therefore, studied the sensitivity of the three methods. This was done by testing platelet-reactive allo-antibodies (anti-Zwa, anti-HLA-A2) and auto-antibodies in titration. The results show that the PSIFT is the most sensitive technique, closely followed by the PRAT. The QACA was found to be much less sensitive than the other two methods. This suggests that a positive result in the QACA and a negative result in the PSIFT and/or PRAT cannot be attributed to the presence of platelet auto-antibodies.